Exploring the fundamental aspects of the Enhanced Recovery After Surgery nurse’s role
Familiarise yourself with the main aspects of this role
11 Nov 2019
Jennie Burch
All nurses have a role in detecting bowel cancer
Nurse Jennie Burch says bowel cancer screening is working – but we must maintain the momentum
12 Dec 2018
Post-discharge care for patients following stoma formation: what the nurse needs to know
Rationale and key points This article discusses post-discharge care for patients following stoma formation. While the patient is taught the practicalities of managing the stoma appliance in hospital, this learning should be integrated into their daily life following discharge from hospital. Nurses are required to consider and address any issues that might affect the patient in the long term. These include changes in body image, adapting to having a stoma, preventing or treating complications associated with a stoma, and long-term follow-up. » Most patients manage successfully with their stoma following a period of adaptation. » Follow-up for patients with a stoma can occur over the telephone and/or face-to-face in the patient’s home or in the clinic. » There are several support groups in the UK that can be accessed by patients with a stoma. » Patients should seek advice and assistance from a stoma specialist nurse if any issues related to the stoma arise, such as leakage or sore peristomal skin.
16 Aug 2017
Care of patients undergoing stoma formation: what the nurse needs to know
Rationale and key points This article provides an overview of the various types of abdominal stoma and surgical procedures that result in stoma formation. It outlines the enhanced recovery pathway that is used to guide postoperative care, and some of the areas that should be incorporated in postoperative stoma care. These areas include training in the practical care of the stoma and its appliance, dietary advice and reintegrating lifestyle activities. In addition, the article briefly examines stoma reversal, and explores the role of the stoma specialist nurse. » Nurses require an understanding of the various surgical procedures that might result in the formation of a stoma. » An understanding of the stoma appliances that are available is essential to enable nurses to provide effective care for patients with a newly formed stoma. » Effective postoperative care that incorporates support and education enables patients to adapt quickly to having a stoma. » Enabling patients to understand changes that occur as a result of stoma formation will increase their confidence in managing their stoma alongside the effect on their quality of life.
07 Jun 2017
Preoperative care of patients undergoing stoma formation: what the nurse needs to know
Rationale and key points This article addresses preoperative care of patients for whom surgery to form a stoma is planned. It discusses conditions that may result in the formation of a stoma, explores preoperative investigations that may be necessary before surgery, outlines various types of stoma and stoma appliances, and offers guidance on preparing patients to manage this lifestyle transition. The stoma specialist nurse has the principal role in providing patient education. However, nurses in all practice settings may encounter patients who are due to undergo surgery to form a stoma, and can provide preoperative support and education. » Nurses require an understanding of the enhanced recovery pathway to support patients who are due to undergo surgery to form a stoma. » Optimal siting of the stoma is essential to enable patient self-care. » Effective preoperative care of patients undergoing planned surgery to form a stoma enables patients to gain independence quickly following stoma formation. » Enabling patients to self-care for their stoma is associated with improved quality of life and enhanced body image.
03 May 2017
Nursing care for patients undergoing pelvic exenteration for rectal cancers
Pelvic exenteration is an established surgical procedure aimed at removing primary locally advanced pelvic cancers or recurrent pelvic cancers. Exenteration is major surgery, involving considerable risk of morbidity and prolonged recovery. Patient suitability should be considered carefully and all potential complications discussed pre-operatively so that patients can make an informed choice about treatment. This article focuses on pelvic exenteration for patients with rectal or anal cancer. The surgery involves removal of the rectum and possibly also the bladder, and therefore stoma formation. In addition to physical challenges, such as pain and fatigue, patients face emotional issues such as altered body image. Nursing care is therefore crucial and, ideally, should be provided by a specialist service to ensure that all members of the multidisciplinary team are able to contribute to patient-centred care. This article explores the elements of nursing care after surgery and in the longer term, including pain management, mobility, nutrition, fatigue, stoma care, continence and support with psychological issues such as sexuality. The management of potential post-operative complications, such as unplanned return to surgery, is also discussed.
10 Oct 2016
Care of patients with peristomal skin complications
Stoma formation is common and may be necessary in the management of certain diseases and as a result of surgery to the gastrointestinal tract or urinary tract. Because stomas provide an alternative route for the excretion of faeces and urine, they can have a significant effect on the individual’s physical, psychological and social functioning. Stomas require careful management and patients need to be taught how to self-care for the stoma and how to recognise common complications. This article focuses on the signs, symptoms and management of peristomal skin complications.
14 May 2014
Enhanced recovery for patients following colorectal surgery
The gastrointestinal tract consists of different organs that may become diseased and require surgery. Colorectal surgery is commonly undertaken for conditions such as colorectal cancer and diverticular disease. This article discusses some of the more common operations to increase the reader’s understanding of colorectal surgery. Enhanced recovery has been undertaken in the UK and Europe for several years. It is a way of improving the experience and wellbeing of patients following surgery by enabling faster recovery and return to normal, minimising post-operative complications such as infection, as well as reducing length of stay in hospital and readmission.
12 Sep 2012